AB0693 IN-OFFICE LACRIMAL BIOMARKERS IN PRIMARY SJÖGREN’S SYNDROME
Authors: F. Morales-Wong, J. C. Riega-Torres, A. J. Cavazos-Tamez, O. E. Alvarez-González, J. Mohamed Hamsho, C. M. Skinner Taylor, D. Á. Galarza-Delgado, K. Mohamed Noriega
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Dry eye disease (DED) is characterized by loss of homeostasis of the tear film, ocular surface inflammation, ocular symptoms and neurosensory abnormalities. [1] The exposure of epithelial surface triggers a series of cellular processes that culminate in an inflammatory mediator increase, which can be measured non-invasively and affordably in a medical office. [2] <h3>Objectives</h3> To compare tear film osmolarity (Osm) and matrix metalloproteinase-9 (MMP-9) inflammatory biomarkers between primary Sjögren's syndrome (pSS) patients and a control group. <h3>Methods</h3> A prospective, cross-sectional and comparative study was conducted as part of a dry eye screening cohort by the ophthalmology and rheumatology services of the Hospital Universitario "Dr. José Eleuterio González". pSS diagnosis was made according to ACR/EULAR 2016 criteria. Control group participants were recruited as part of dry eye screening evaluations in general population. Patients under 18 years old, history of ocular disease not related to pSS, ocular surgery in the last 3 months and contact lenses wearers were excluded. All participants underwent the following dry eye tests: tear film Osm, tear film MMP-9, ocular surface disease index (OSDI) questionnaire, tear breakup time (TBUT), sicca ocular staining score (OSS), Schirmer without anesthesia (SCH) and corneal sensitivity. <h3>Results</h3> One eye per patient was included, 76 with pSS and 76 age- and sex-matched controls. Mean age was 53.0 ± 12.7 and 53.4 ± 16.2 (p=0.955) in pSS and control group respectively. The majority were women in pSS (74, 97.4%) and controls (74, 97.4%). We found a significant difference in the prevalence of comorbidities, with hypothyroidism (12, 18.8% vs. 1, 1.3% <i>p</i>=0.002) and depression (7, 9.2% vs 0 <i>p</i>=0.007) being more frequent in the pSS group than controls. In pSS and controls, Osm was 316.05 ± 25.54 vs 305.13±17.22 (p=0.010), positive MMP-9 in 19 (25.0%) vs 7 (9.2%) (p=0.017), OSDI was 43.52 ± 24.09 vs 34.09 ± 21.15 (p=0.012), TBUT 5.04 ± 3.36 vs 6.48 ± 2.76 (p &lt;0.001), OSS 7.12 ± 3.50 vs 1.83 ± 1.70 (p&lt;0.001), SCH 10.91 ± 10.05 vs 15.70 ± 9.60 (p&lt;0.001) and sensitivity 5.56 ± 1.01 vs 5.91 ± 0.28 (p=0.032) respectively. No significant correlation was found between Osm and other dry eye variables. <h3>Conclusion</h3> Patients with pSS had higher Osm and OSDI, as well as more prevalence of MMP-9 detection than controls, and lower TBUT, Schirmer and corneal sensitivity. More information is needed to determine the role of tear film osmolarity and MMP-9 in the tear in the diagnosis and prognosis of pSS. However, biomarker tests are useful for the diagnosis and severity stratification of DED, being non-invasive, affordable and easy to use in the medical office. <h3>References</h3> [1]Craig JP, Nichols KK, Akpek EK, et al (2017) TFOS DEWS II Definition and Classification Report. Ocul Surf 15:276–283. https://doi.org/10.1016/j.jtos.2017.05.008 [2]Fong PY, Shih KC, Lam PY, Chan TCY, Jhanji V, Tong L. Role of tear film biomarkers in the diagnosis and management of dry eye disease. Taiwan J Ophthalmol. 2019 Sep 12;9(3):150-159. doi: 10.4103/tjo.tjo_56_19. PMID: 31572651; PMCID: PMC6759547. <h3>Acknowledgements</h3> No acknowledgements to declare. <h3>Disclosure of Interests</h3> None Declared.